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Sample letter requesting accommodation from employer

Accommodation letter to employee 2026

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The document is an 'Employee Request for a Reasonable Accommodation' form designed to assist employees in requesting accommodations due to disabilities. It outlines the process for submitting a request, including the need for a Medical Response form to be completed by the employee and their physician. Employees are instructed to provide details about their functional limitations and specific accommodation requests without disclosing medical diagnoses.

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Click ‘Get Form’ to open the accommodation letter in the editor.
Begin by entering the date at the top of the form. This helps establish a timeline for your request.
Fill in your name, job title, and department accurately. This information is crucial for identifying you within the organization.
Provide your supervisor’s name to ensure that your request reaches the appropriate person for review.
In the section regarding functional limitations, describe how your disability affects your job duties without revealing any medical diagnoses.
Clearly state your request for reasonable accommodation, such as adjustments to work hours or changes in equipment. Be specific to facilitate understanding.
Once completed, save and share the document with your supervisor and email a copy to Elizabeth Delo at Disability Services using our platform's sharing features.

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